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Mode of action:
Dikloberl - steroidal anti-inflammatory agent, a derivative of phenylacetic acid. The active ingredient is diclofenac sodium. Has a pronounced anti-inflammatory effect by inhibiting the synthesis of prostaglandins. Has antipyretic, analgesic and anti-edema (swelling of the tissues during inflammation) effect. Reduces the adhesion of platelets by the action of collagen and ADP.
In parenteral (intramuscular) administration, Cmax in plasma observed in 10-20 minutes. Following oral administration, diclofenac is completely absorbed from the intestine. Cmax in plasma observed after 1-16 hours (average data - after 2-3 hours). After absorption from the intestine is carried out first-pass metabolism through the primary passage through the liver. In postpechenochnuyu circulation misses 35-70% of active ingredient. After insertion of the suppository into the rectum Cmax in plasma observed after 30 minutes.
Approximately 30% of diclofenac is metabolised. The metabolic products are eliminated in the intestine. Inactive metabolites produced by the conjugation and hydroxylation of hepatocytes are eliminated by the kidneys. The half-life of 2 hours and not dependent on renal and liver. Binds to blood proteins 99% of the drug.
Indications for use:
• Rheumatic diseases (rheumatoid arthritis, rheumatism, osteoarthritis),
• ankylosing spondylitis,
• gout,
• degenerative joint disease,
• pain in injuries of the musculoskeletal system and (or) soft tissue
• neuralgia,
• myalgia,
• primary dysmenorrhea.
How to use:
Dikloberl 75 for parenteral injection is administered in the gluteal muscle (deep intramuscular injection). The daily dose - 75 mg (1 ampoule). The maximum daily dose - no more than 150 mg. If you need long-term treatment dikloberlom prescribe oral or rectal forms.
The tablets are taken orally dikloberl 50 during the meal (to avoid irritating effect on the mucous membrane of the stomach), with a small amount of liquid. Do not chew. Daily dose - 50-150 mg - divided into 2-3 doses. The duration of therapy is determined by the physician individually.
Dikloberl retard capsules are taken one time a day (100 mg). If necessary, increase the dose used pills dikloberl 50.
Suppositories dikloberl 50 injected deep into the rectum after a bowel movement. The dose is determined individually by the physician according to the severity of the disease. The daily dose should be in the range of 50-150 mg (adults and pediatric patients older than 15 years). The daily dose is administered in 2-3 divided doses.
Side effects:
The gastro-intestinal tract: dyspepsia, glossitis, esophagitis, liver damage, exacerbation of gastro-intestinal diseases, pancreatitis, constipation, abdominal pain, vomiting, diarrhea, nausea, loss of appetite, slight gastrointestinal bleeding in patients with diseases GI bleeding can be observed and ulcer perforation. In rare cases - melena, bloody vomiting, bloody diarrhea.
The central nervous system: dizziness, headache, insomnia, fatigue, agitation, changes in taste, sensory disturbances, changes in the perception of sounds, visual disturbances, confusion, feelings of fear, seizures, nightmares, depression, tremors, muscle rigidity neck (aseptic meningitis), confusion.
Allergic reactions: skin rash, bullous rash, itching, burning sensation at the injection site, sterile abscess at the injection site, Lyell's syndrome, necrosis of the subcutaneous fat tissue at the injection site, swelling of the tongue, face and throat, Stevens - Johnson, anaphylactic shock, bronchospasm .
Blood system: thrombocytopenia, anemia, agranulocytosis, leukopenia.
Cardio-vascular system: chest pain, palpitation, reduction in blood pressure, hypertension.
Other: possible deterioration of the general condition for necrotizing fasciitis, pneumonitis, allergic vasculitis.
Contraindications:
• Diclofenac allergic reaction (or other drugs from the group of non-steroidal antiinflammatory drugs)
• stomach ulcer or duodenal ulcer,
• peptic ulcer,
• gastrointestinal bleeding,
• violations of blood,
• asthma,
• Age less than 15 years.
Pregnancy:
Dikloberl contraindicated for pregnant women and breast-fed.
Interactions with other drugs:
Receiving Frequency dikloberla against phenytoin, digoxin, drugs lithium content of the latter increases in plasma. When co-administered with diuretics and means for reducing hypertension decreases the effectiveness of the latter. When combined with potassium-sparing diuretics observed increase in the concentration of potassium in the blood.
The combination with inhibitors of angiotensin-converting factor can induce renal dysfunction. In combination with corticosteroids and other nonsteroidal anti-inflammatory drugs amplified side effects on the gastrointestinal tract.
Applications per day before or after the observed increase in the concentration of methotrexate and methotrexate amplification its toxic effects. If concomitant use of antiplatelet agents requires medical monitoring of blood coagulation (though the interaction is not detected).
In combination with cyclosporin increased toxicity of cyclosporine. Funds with probenecid slow excretion of diclofenac.
There are few reports of change of glucose in the blood serum of patients with diabetes who require insulin dose changes and antidiabetic drugs.
Overdose:
Overdose require symptomatic treatment. Dizziness, headache, loss of consciousness, disorientation, myoclonic seizures in children, vomiting, nausea, abdominal pain, impaired renal and hepatic function, gastro-intestinal bleeding.
Product:
Dikloberl 75 - solution for injection in 3 ml vials (75 mg). In a cardboard box 5 vials.
Dikloberl 50 - tablets enteric coating 50 mg. In the blister pack of 50 or 100 tablets.
Dikloberl retard - sustained-release capsules of 100 mg. In the blister 10, 20 or 50 capsules.
Dikloberl 50 suppositories - suppositories for rectal administration of 50 mg. In the blister pack of 5 or 10 suppositories.
Storage:
The temperature is not above 25 ° C. In a dark place, out of reach of children.
Synonyms:
Diclofenac sodium
Ingredients:
Dikloberl 75 (parenteral administration):
Active ingredients: Diclofenac sodium (75 mg).
Inactive ingredients: benzyl alcohol, propylene glycol, sodium hydroxide, mannitol, acetylcysteine, water for injections.
Dikloberl - tablet:
Active ingredients: Diclofenac sodium (50 mg).
Inactive Ingredients: corn starch, methacrylic acid - ethyl acrylate copolymer (1:1), talc, lactose monohydrate, povidone K30, magnesium stearate, sodium carboxymethyl starch, 30% dispersion - dry mass zhelezokisly Pigment Yellow (E172), simethicone emulsion, macrogol 400, titanium dioxide (E171), hypromellose, macrogol 6000.
Dikloberl-retard:
Active ingredient: diclofenac sodium (100 mg).
Inactive Ingredients: corn starch, oydragit RL 12,5, titanium dioxide, sucrose, shellac, white gelatin, talc.
Dikloberl suppositories:
Active ingredients: Diclofenac sodium (50 mg).
Inactive Ingredients: 96% ethyl alcohol, tallow, corn starch, propilgalat.
In addition:
In diseases of the gastro-intestinal tract (Crohn's disease, peptic ulcer, ulcerative colitis, liver disease) induced porphyria, kidney disease, hypertension, cardiovascular disease, autoimmune pathologies, individual hypersensitivity to non-steroidal anti-inflammatory agents, elderly patients in the postoperative period in patients with diseases of the respiratory tract of atopic character used with caution under constant medical supervision.
After the injection, the patient should be under medical supervision for 1 hour.
The drug can affect (particularly with concomitant use of alcohol) on the ability to drive vehicles and work with complex dangerous machinery. If you need long-term treatment dikloberlom want to monitor liver and kidney function, electrolytes and blood glucose levels.
